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Hysterectomy Surgery: Uterine Care

Hysterectomy Surgery

What Is Hysterectomy Surgery?

The procedure of gynecology which deals with the surgical removal of uterus is known as hysterectomy. The uterus may be removed partly leaving the cervix intact or maybe removed completely along with the cervix. An additional procedure may be required on the surgical table to remove the ovaries and the fallopian tubes. These procedures are known as oopherectomy and salpingectomy respectively and shall be discussed in the following text.

Causes of Uterus Diseases:

  • Mental stress, emotional distress, hormonal imbalance
  • Tumors and cysts occur in uterus, ovaries as a result of hormonal imbalance, trauma in the pelvic region
  • Uterine fibroids follow the same etiological pattern
  • Cervical and vaginal infections may occur due to bacteria/virus/fungus due to poor hygiene maintenance
  • Fallopian tube blockages may lead to infertility
  • Miscarriages can occur due to weak uterus, faulty or improper implantations in the uterine walls

Signs and symptoms Of Uterus Diseases:

  • Irregularity in the menstrual cycle
  • Heavy bleeding during cycles, bleeding in between two cycles
  • Pain and discomfort in the lower abdomen area
  • Delay in achieving menopause, bleeding continuing even after menopause
  • Foul discharge from the vagina, pus discharge at times
  • Frequent urge to urinate, painful urination
  • Nausea, vomiting, mood swings, irritability

Diagnosis of Uterus Diseases:

  • Blood/urine test: These are done to evaluate the levels of hormones such as estrogen, progesterone and human chorionic gonadotropin. Urine is also looked for presence of any abnormal or pus cells.
  • Biopsy: It is a procedure followed to distinguish a benign tumor from a malignant one, study the nature, type and progress of the tumor/cancer mass. A small portion of the mass is excised and sent to the labs for histological examination. Routinely done for tumor masses and fibroids in the uterus.
  • Fine needle aspiration cytology FNAC:  For any cysts in the uterus, a long tubular needle can be inserted to aspirate the cystic contents into it again to study the type, nature and progress of the cystic cavity.
  • PAP test: It is also a histological method in which smears are prepared from the samples obtained from biopsy and FNAC to study the type and structure of cells present in the pathologic condition.
  • Ultrasound USG: It is a non ionizing radiation technique which uses sound waves to study the internal structure of organs. Any abnormal mass in the reproductive system, lymph nodes draining them can be detected with the help of it.
  • Hysteroscopy: A long thin tube like structure is inserted into the uterus via the vagina and the entire uterine walls with the endometrium can be seen projected outside on a screen.
  • Trans-vaginal ultrasound: It is done exclusively to determine the vaginal opening, vaginal length and study the vaginal walls.

Types Of Uterus Diseases:

Uterus is a hollow muscular organ located in the pelvic region in females, serving as a site for implantation of the fetus and marking the onset of pregnancy. The connective tissue of the endometrium is highly prone to disorders such as fibroids/myomas/liomyomas. These are masses of variable hardness consisting of smooth muscles and fibres. They may or may not be symptomatic and often may go undiagnosed. Uterine cancer might be the ultimate cause if the mass increases in size and number obliterating the uterine functions. Endometrial polyps are hanging tube like small structures which may develop where atypical cells multiply at abnormal pace. They can also be considered as  mole or wart like bumps in the endometrium. Polpys usually cause friction and lead to internal bleeding, however also possess a tendency to turn into malignancy. Endometrial hyperplasia on the other hand occurs due to excessive levels of estrogen in the blood. This hormone produced by the ovaries, is responsible for the growth of endometrial lining. High levels of it cause abnormal swelling and layering of the uterine lining.

 

Fibromas, cysts, polyps, inflammation and hyperplasias also may occur in the cervix (birth canal) and vagina which are the narrower and descending parts of uterus. Cervical cancer being the most common and popular, may occur post parturition or may also show unknown etiology, often accompanied by severe lower body pain, cervical and vaginal discharges, pain on urination in addition to the abnormal multiplication of atypical cells in the cervix.

 

One of the most common ovarian diseases in females in the 18 to 40 age group, polycystic ovarian disorder/syndrome i.e PCOD/PCOS, occurs due to higher than normal levels of androgens in blood which prevent ovaries from releasing eggs at a normal rate and time. The follicles in turn develop into rudimentary cysts, result in irregular menses, abnormal hair growth and acne. Ovarian cysts develop within the follicles and may cause swelling of the ovaries, irregular bleeding, pain and tenderness in the lower abdomen region.

Treatment Procedures for Hysterectomy Surgery:

Once all the diagnosis has been done, it becomes mandatory for the surgeon to take into account the overall health of the female and then decide on the approach that will be used to remove the uterus. There are two types of surgical approaches, these are:

  1. Open hysterectomy surgical method
  2. Minimally invasive surgical method

In an open type of approach, a conventional method is followed in which long incisions are made in the lower abdomen in a horizontal direction and in the sides followed by step by step opening of layers of skin and fascia and ultimately removing the uterus.

A minimally invasive type of approach can again be done by four different methods. These are as follows:

  1. Vaginal hysterectomy: In this method, an incision is made in the vagina and through this tunnel the removal of uterus is accomplished. It prevents the formation of scar tissues
  2. Laparoscopic method: This approach makes use of a laparoscope which is long tube at the terminal end of which a small camera is attached. This tube when inserted through the incision in the belly button makes visibility clear of the structures inside the uterus on a screen projected outside. With the assistance of this, the uterus removal can be done.
  3. Laparoscopic assisted vaginal hysterectomy: This makes use of both the vaginal approach for incision and the laparoscope for the removal location of uterus.
  4. Robot assisted laparoscopic hysterectomy: It is quite a recent trend in the field of surgery in which advanced surgical equipments enable a three dimensional movement of the instrument outside the body and thus enable no operating no human hands as such on the patient.

The hysterectomy surgery itself can be of various types as follows:

  • In a total hysterectomy procedure, the entire part of uterus and the cervix are removed. This is mostly the choice in cases of uterine cancer.
  • In a partial hysterectomy procedure, part of uterus above the cervix is removed leaving behind the cervix and portion below it intact.

In many cases, ovaries may also have to be removed. In such times, they are removed on the surgical table in one go with the uterus. Fallopian tubes removal may also be required along with the removal of the ovaries. When the uterus-ovaries and fallopian tubes are removed in tote, the procedure is known as hysterectomy-oopherectomy-salpingectomy.

Complications And Risk Factors Associated With Hysterectomy Surgery:

  • Infections most commonly occur in the suture areas
  • Delayed healing may lead to further complications in the suture area
  • Scar formation gives the abdomen an ugly appearance
  • Bleeding post operatively may get difficult to manage
  • Calcium efficiency and excess weight gain can become a threat

Am I A Good Candidate For Hysterectomy Surgery?

If you continue to bleed and suffer from abdominal pain and discomfort even after menopause, or achieving menopause seems distressing, with a total certainty for uterine cancer, you surely are a candidate for hysterectomy surgery procedure.

Benefits:

  • The procedure prevents excessive blood loss from the body
  • Restores the lost hormonal balance in the body
  • Prevents the chances of cysts, tumors and fibroids turning into cancers
  •  Ease outs the normal functioning of the female human body

Why Choose India?

Taking into the consideration the diversity in the professional skills and knowledge of the surgeons and gynecologists in India, we at MedcureIndia assure our clients of the best treatment modality offered to them at very affordable costs.